Wutzler A, Kloppe C, Bilgard A K, Mügge A, Hanefeld C
Heart and Vascular Center, Ruhr University Bochum, St. Josef Hospital, Bleichstr. 15, 44787, Bochum, Germany.
Department of Internal Medicine, Ruhr University Bochum, St. Elisabeth Hospital, Bochum, Germany.
Med Klin Intensivmed Notfmed. 2019 Mar;114(2):154-158. doi: 10.1007/s00063-017-0377-7. Epub 2017 Nov 7.
Acute treatment of in-hospital cardiac arrest (IHCA) is challenging and overall survival rates are low. However, data on the use of public-access automated external defibrillators (AEDs) for IHCA remain controversial. The aim of our study was to evaluate characteristics of patients experiencing IHCA and feasibility of public-access AED use for resuscitation in a university hospital.
IHCA events outside the intensive care unit were analysed over a period of 21 months. Patients' characteristics, AED performance, return of spontaneous circulation (ROSC) and 24 h survival were evaluated. Outcomes following adequate and inadequate AED use were compared.
During the study period, 59 IHCAs occurred. AED was used in 28 (47.5%) of the cases. However, AED was adequately used in only 42.8% of total AED cases. AED use was not associated with an increased survival rate (12.9 vs. 10.7%, p = 0.8) compared to non-AED use. However, adequate AED use was associated with a higher survival rate (25 vs. 0%, p = 0.034) compared to inadequate AED use. Time from emergency call to application of AED >3 min was the most important factor of inadequate AED use. Adequate AED use was more often observed between 7:30 and 13:30 and in the internal medicine department.
AEDs were applied in less than 50% of the IHCA events. Furthermore, AED use was inadequate in the majority of the cases. Since adequate AED use is associated with improved survival, AEDs should be available in hospital areas with patients at high risk of shockable rhythm.
医院内心脏骤停（IHCA）的急性治疗具有挑战性，总体生存率较低。然而，关于使用公共场所自动体外除颤器（AED）治疗IHCA的数据仍存在争议。我们研究的目的是评估在大学医院发生IHCA的患者特征以及使用公共场所AED进行复苏的可行性。
对重症监护病房以外21个月期间发生的IHCA事件进行分析。评估患者特征、AED性能、自主循环恢复（ROSC）和24小时生存率。比较AED使用充分和不充分情况下的结果。
在研究期间，共发生59例IHCA。其中28例（47.5%）使用了AED。然而，在所有使用AED的病例中，只有42.8%的AED使用是充分的。与未使用AED相比，使用AED并未提高生存率（12.9%对10.7%，p = 0.8）。然而，与AED使用不充分相比，AED使用充分与更高的生存率相关（25%对0%，p = 0.034）。从紧急呼叫到应用AED的时间>3分钟是AED使用不充分的最重要因素。在7:30至13:30之间以及在内科，更常观察到AED使用充分的情况。
在不到50%的IHCA事件中应用了AED。此外，在大多数情况下AED使用不充分。由于AED使用充分与生存率提高相关，因此在有可电击心律高风险患者的医院区域应配备AED。
